• Johnna Schölin, Mark Buunen, Wim Hop, Jaap Bonjer, Bo Anderberg, Miguel Cuesta, Salvadora Delgado, Ainitze Ibarzabal, Marie-Louise Ivarsson, Martin Janson, Antonio Lacy, Johan Lange, Lars Påhlman, Stefan Skullman, and Eva Haglind.
• Department of Surgery, Område 2, Sahlgrenska University Hospital/Östra, SE-416 85 Göteborg, Sweden.
• Surg Endosc. 2011 Dec 1;25(12):3755-60.

BackgroundPostoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared.MethodsA retrospective analysis was performed, collecting data of episodes of bowel obstruction with or without surgery. Only episodes treated in the hospital where the index surgery took place were included. Data for 786 patients were collected for the 5-year period after cancer surgery.ResultsBaseline characteristics for the evaluated laparoscopic (n = 383) and open (n = 403) groups were comparable. The cumulative obstruction percentages at 5 years for the open and laparoscopic groups were 6.5 and 5.1% respectively and did not significantly differ from each other. Tumor stage seemed to influence the risk for bowel obstruction: 2.8% in stage I, 6.6% in stage II, and 7% in stage III, but the differences were not significant.ConclusionsThis analysis does not support the hypothesis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery.

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